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Shortage of Anti-cancer Drugs Greatly Impacts Iraqi Children With Leukemia
The U.N.-ordered sanctions were imposed in 1990 after the invasion of Kuwait and remained in effect until 2003. During the sanctions, there was a widespread shortage of medications, including antibiotics and chemotherapeutic drugs.
“We wanted to determine if the reduction in the availability of chemotherapeutic agents resulted in actual changes in health outcomes for Iraqi children diagnosed with acute lymphocytic leukemia,” said Haydar Frangoul, M.D., associate professor of Pediatrics and director of the Pediatric Stem Cell Transplant Program at Vanderbilt-Ingram Cancer Center.
Frangoul and colleagues from the Baghdad Medical College studied the medical records of 651 children diagnosed with acute lymphocytic leukemia (ALL) who were treated at the Children’s Welfare Teaching Hospital in Baghdad.
Chemotherapy shortage was immediately observed after the implementation of the U.N. sanctions in 1990 but there was an incremental decrease in chemotherapy availability during the study period. The proportion of patients receiving less than 50 percent of their prescribed chemotherapy due to shortages increased from 20.1 percent between 1990 and 1994, to 54.3 percent between 2000 and 2002.
The researchers discovered that the overall survival rate was significantly higher for patients who received all of the prescribed dosages (80 percent versus 55 percent respectively). The difference in survival rates was significant whether the patients were considered to be in a standard risk group or a high-risk group.
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